Who will be studied?

We are inviting veterans of the British nuclear testing programme, their spouse or partner, and a biological child they have together, to participate. Test veterans are identified from records of personnel who served in at least one nuclear test operation during the 1950s and 1960s. We are also inviting military veterans who served in the tropics over the same time-frame but who are verified as not being present at any nuclear test site. In total we are including 100 military veteran family trios. Half the veterans in the study will have been at British nuclear test sites and half (the control group) will have served elsewhere in the tropical region.

What does the study involve?

Invited families who consent to take part will be contacted by the study team and arrangements made to have a small blood sample collected. The blood sample will then be sent to Brunel University London and University of Leicester for analysis.

How are we selecting veterans?

The test veterans are being selected from the ‘Nuclear Test Veteran Cohort,’ the largest known database of UK test participants. This cohort was originally made up of over 20,000 veterans verified to have been present at one or more nuclear test sites and control veterans verified not to have been present at test sites. We have been approved to use a method of ‘stratified random sampling’ to focus on those veterans with a higher likelihood of being exposed to radiation. We reason that if there are any detectable differences between test and control veterans then we are most likely to detect them using this particular sampling approach.

We will be looking for genetic differences set against a lifetime of exposure to a global background of radiation from a variety of sources including radon gas in the environment, global fallout, medical & diagnostic exposures as well as other confounding effects.

Can I volunteer?

No. Some studies, such as this one, are designed to invite specific groups of people to participate which means that individuals cannot request to join. In this study we have focused on veterans who were the most likely to have been exposed, for example those who carried out specific high risk duties such as cleaning contaminated aircraft. Because we are using this stratified random sampling approach, it unfortunately prevents individuals from proactively volunteering. Our approach lessens the impact of any selection bias that would occur if we did accept proactive volunteers.

If I receive a letter and agree to participate will I definitely be recruited into the study?

No. First, we will need to verify eligibility criteria for you, your partner and your child. Once that is confirmed we will then need to obtain written consent from you all.

Shall I contact my GP to ask to be included in the study?

No. Your GP cannot ask for you to be included in the study, however you could enquire if they have received any invitations from our study team in case they have yet to forward this to you.

Can I refuse to participate or withdraw at any time?

Yes. If you do not wish to be contacted to participate or, if you wish to withdraw you may do so at any time. Please contact the study team at the London School of Hygiene & Tropical Medicine on telephone number 020 7927 2722 or email VETS@LSHTM.AC.UK to advise accordingly.

When will we know the results of the genetic study?

Undertaking a research project is a lengthy exercise. If you think about this project as comprising four major bodies of work.

Firstly, all studies involving human participants are legally and ethically obliged to obtain UK regulatory permissions. For this study, many stages of approval were required. All stages progressed without issue, however in total this took 17 months to complete.

Secondly, upon approval, the process of inviting and recruiting families to participate could begin. This requires a significant effort from the study team and involves sending hundreds of ‘invitation packages’ to identified veteran couples via their GP. There are many steps involved in administering this process and in the subsequent screening and interviewing of eligible and consented individuals.

Thirdly, once informed consent has been obtained from all members of each family trio, blood packages can be sent. Families are requested to make appointments at their local GP to sample their blood and for this to be sent to Brunel University London.

Research staff then process this blood for cytogenetic analysis at Brunel University London and for whole genome sequence analysis at the University of Leicester. This process of analysis involves the detailed assessment of hundreds of cells from every individual in the study and also, computational analysis of large DNA sequence databases for each family. All of this analysis is currently underway and is being carried out in parallel with ongoing family recruitment.

Fourthly, once all of the cytogenetic and whole genome sequence analysis has been completed for all 50 test and 50 control family trios, we can then proceed to performing a number of statistical comparisons to evaluate if any differences are seen between test and control populations that show evidence, or not, for a genetic effect of participating at British nuclear test sites. Once this assessment of the data has been made, the results will be written and submitted for peer-review publication in scientific journals. It is only upon acceptance for publication that all of our findings can be made public.

We anticipate publication of findings early 2022.

How is the study progressing so far?

Since we received the go-ahead to start recruitment, we have been progressively moving towards our target. The numbers are changing all the time and in-line with expected rates. The whole process of sending invitations is done in batches which we do for processing purposes, this of course is all overlapping with the receipt of samples from families already recruited meaning analysis is well underway.

Can you answer our questions on our family’s medical conditions?

No. CHRC is not a clinical facility and we are not medically qualified. We cannot provide any tests or offer any medical advice to any individual directly and recommend that if you have concerns to seek guidance from your GP.

Can I send samples of DNA to your lab?

No. For legal and ethical reasons, we are unable to accept biological samples outside of current approved studies e.g. the genetics study.

Are you going to expand your research for other veteran and exposed populations?

Yes. We are actively exploring a number of opportunities to build on the range of projects currently underway at CHRC. This involves building networks with national and international scientists to develop research that will address outstanding gaps and to successfully secure research funding to carry this work out.

Has the radiation my father received caused ill health in me or my children?

The overwhelming evidence to date is that there is no verifiable epidemiological evidence that exposure to radiation in a parent before conception will lead to ill-health in the children. Families should be reassured by this. There is credible experimental evidence in cell and animal-based models for some effect however which is why international research into this question continues, including our current genetic study which is underway.

Do you have any other projects that I can get involved in?

Yes. PhD project ‘Exposure Worry, Ageing and Cognitive Functioning'. Summary of project can be found  here.